Sunday 30 October 2016

An Undergraduate Perspective on Recovery

Written by Krishna Udaiwal

In the winter semester of my second year undergrad for philosophy/biology major, I underwent a period of uncontrolled pressure and a breaking point leading to severe depression & social anxiety, as well as cancelling the entire semester before the exams. It was a horrible experience, one which I wouldn’t prescribe to my worst enemies. During the worst of it, there was a breakdown event, loss of interest, severe self-deprecation and quarantine-like isolation. Fortunately, I took the seemingly irrational, but courageous, step to book an appointment with a doctor. Unfortunately, it was over 3 weeks after the initial month of agonizing despair, where hounding social anxiety tried to convince me to cancel the appointment (luckily, I hated using the phone or going outside even more). My decision wasn’t irrational and was the best course of action possible. It was the lowest consecutive time for me, where hearsay cases of micromanaging students ‘faking’ mental health conditions for advantage/grades (in my opinion displaced competitiveness from instructors) and my own lack of self-confidence/ineptitude initially deferred me from making that appointment. When learning of diseases & conditions the first lesson is to never self-diagnose, which is equally true for self-un-diagnosing mental health; you inherently cannot make an accurate judgment. It is essential to speak with a trustworthy source.
Once I spoke to the doctor (or General Practitioner, GP, in mental health lingo) it was obvious to them I needed medical help due to physical & mental signs, although some may not present any signs at all. The signs at my stage were tremors (without any stimulants), inability to look directly at someone, muffled speech, inability to focus or calm myself (these are self-observations post facto). GPs are, as they ought be, limited in declaring specific diagnosis & treatments in a single visit (for long-term diagnoses) as there may be false-positive cases (like hearsay cases) as mentioned before. As such, I was referred to a psychiatrist for in-depth analysis of my condition. For the immediate alleviation of my symptoms, I was conveyor-ed through a passive regiment of steps to recovery including counsellor visits to mitigate immediate risk and the psychiatrist diagnosis for long-term specific severity analysis. In addition, on-going appointments with my GP were booked immediately to ensure my condition did not break me off from seeking help, as very likely. Lastly, I was scheduled to speak with an academic counsellor to contemplate my options regarding my semester (they also immediately understood the gravity of my condition and weren’t intrusive, likely being used to such). Further medical treatments were thereafter discussed with the GP in consequent talks.

My GP was closely linked with the university healthcare network, so a passive & systematic approach was in-place to handle my situation. I could only hope to have a similar regiment should I have approached another unlinked GP, where an active search for information would be left up to the distressed student. Very likely, the student may have a better chance by breaking down the issue into personal rehabilitation & academic recovery.

Personal rehabilitation must necessarily take precedence, as the self-development requires a ready mind, which mental health issues take away. Self-development is necessary & core to studying at University. For my preservation, the actions undertaken were recurring GP appointments, counsellor visits, psychiatrist diagnosis and an appointment with the academic counsellor. The first three were part of personal rehabilitation and I would like to briefly summarize why they were necessary. Recurring GP appointments are, concurrent with the counsellor & psychiatrist appointments, for making the overall decisions in regards to personal rehabilitation options from mental health diagnoses. The treatment options usually include cognitive/speech therapy and medication. With each mental health disorder (anorexia, OCD, depression, etc) there are a multitude of different possibilities, so cognitive therapy and/or medication may work better alone or in combination. The psychiatrist is a specialized doctor who has the training and knowledge to accurately make mental health diagnoses, and to a much greater extent than a GP. Thus, GPs seek a psychiatrist’s diagnosis & recommendations, to determine if cognitive therapy and/or medication may be best. Any treatment prescribed depends on the patient’s approval, where patients may be against medication in some cases. In the case of depression, various medications target different neurotransmitters against potential chemical imbalance. Unfortunately, as causes vary and understanding is lacking, non-chemical imbalance causing depression leads to failed treatment by medication, off-putting many patients due to side-effects. Often, the timeframe towards making a diagnosis may be long, therefore a counsellor is needed to relieve pressure and defuse immediate thoughts of self-harm. A counsellor however is not a doctor nor is allowed to diagnose or prescribe therapies/medications to patients, but is very helpful towards the ongoing recovery. In summary, all three are usually needed for higher chances of rehabilitation.

Regarding academic recovery, it depends on your faculty, where different options may be present including cancelling the semester, deferring the exam (& shifting weight all to the exam), or continuing under variable accommodations discussed as per need. Unfortunately, my perspective is limited, as described previously, to what my academic counsellor allowed. I would not expect much creativity from academic counsellors however, as personal experiences & interactions highlight that they aren’t allowed to do much for undergrads anymore, more so within larger faculties.

Lastly, I want to mention during therapy, I learned that ‘suicidal thoughts weren’t normally present’ in healthy individuals. After partial results from treatment, it was apparently true. In addition, the rate of self-loathing thoughts decreased exponentially, as well as their severity, to metaphoric levels between bully-laughed at within a class of students to taking a vacation-nap on an isolated beach. Sure, the isolated beach may lead to some anxiety of unknown lurkers away from the beachfront, but only to such an amount that probability rules in relaxation. Since the hazardous time, I have also experienced that those vile thoughts can be relieved from socializing with trusted compatriots, which may be lacked within the isolated student. The academic environment where learning is secondary to undergrad hierarchy (GPA -> grants, graduate programs, competitive jobs, self-confidence to seek help/opportunities from instructors) reinforces that notion for introverts. After all, it is random chance that guides forming a friendship between two individuals.

I sincerely hope, if you are undergoing suicidal thoughts, you will talk to someone you can trust or a telephone helpline. Please don’t speak to former abusers, whom you have a history with no matter how optimistic. If you feel self-deprecating, seek a volunteer organization where people appreciate you so you can regain some of your spirit, this being my method towards personal well-being post-therapy. If you’re in a temporary crisis mode, or over-stressed, change your objectives to personal well-being immediately! An assignment or test can be deferred or re-weighted, but a breakdown has lasting consequences. You are not the first to be in crisis, and the faculty must accommodate.

If you feel of no consequence, let me know and I can try to brainwas—I mean encourage you towards some social causes I believe could use additional help (after some semblance of recovery of course). For instance, international agriculture, medical aid, food miles, local communities, cycling and botany.

 About the Author
Krishna Udaiwal, BSc, affected 2nd year of undergrad, dealing with the complications one at a time. Still impassioned & always reading on molecular life of plants and miRNA, aiming for MSc. Promoting science communication on Twitter, and always happy to help peers.

Friday 21 October 2016

Developing Disability Cultural Competence

Written by Rosemarie Garland-Thomson 
Here’s my advice for people with disabilities so they can come out and flourish in the professional environment. Our ultimate goal is to develop disability cultural proficiency. This begins with disability cultural competence, which is learning how to live effectively as a person with disabilities, not just living as a disabled person trying to become non-disabled. Competence moves toward proficiency as one carries out living with a disability over time and working toward achieving a high quality of life while living with a disability.
Developing disability cultural competence begins with identifying openly as a person with disabilities. Cultivate dignity and authority as a person with disabilities. Enter into organizations and communities that offer support, resources, groups, and gathering opportunities for people with disabilities. Find like-minded colleagues and friends who have disabilities.
As a person who identifies as disabled, know your rights, protections, opportunities, information, culture, history, and communities that can support your flourishing as a disabled person. Learn about requesting accommodations in your workplace, accessing resources and information, and getting physical access. Go to the disability resource center or office of disability services and register as a disabled person so you can request accommodations and know what services and technologies are available to you in the workplace. It should be that office, not your supervisor with whom you discuss your access and accommodation needs. You should not disclose to your supervisors your medical diagnosis, but rather focus on the accommodations you require to carry out workplace expectations. And especially, your supervisors should not be deciding whether or not to grant you accommodations for your disabilities.
Learn to use public resources and supportive structures for people with disabilities. Consider accessible reduced entrance fees for people with disabilities, transportation options, and research how to get proper documentation and procedures for other benefits for disabled people in public space venues.
Most important is to know and use the rights, benefits, and protections provided in the Americans with Disabilities Act (ADA) or your national and local codes and policies for assuring disability equity and nondiscrimination. Go to the ADA website. Read the United Nations Convention on the Rights of People with Disabilities (UNCRPD) if your country has adopted the treaty. Find out about its implementation in your employment and public environment.
In short: know your communities; know your rights; know your access needs; know your accessible technology.


 About the Author
Rosemarie Garland-Thomson is Professor of English and bioethics at Emory University, where her fields of study are disability studies, American literature and culture, bioethics, and feminist theory. Her work develops the field of critical disability studies in the health humanities, broadly understood, to bring forward disability access, inclusion, and identity to communities inside and outside of the academy. She is the author of Staring: How We Look and several other books. Her current book project is Habitable Worlds: Toward a Disability Bioethics.